Chemical cystitis may result from oral therapy with drugs such as cyclophosphamide, protamine sulfate, acetone, and from vesical instillation of various other chemical agents. One hypothesis concerning the etiology of various forms of cystitis relates to a defunctionalized and damaged bladder urothelial surface with subsequent penetration of substances in the urine into the bladder wall causing inflammation and increased permeability. Protamine sulfate has been used to effectively damage the mucin layer and urothelium of the bladder inducing cystitis. The addition of uric acid enhances the severity of the cystitis.
One of the major etiologies of the damage to the urothelium in chemical-induced models of cystitis is oxidative stress. Natural products showing antioxidant activity in several types of chemical cystitis have been shown to be effective in their treatment. It was reported that reduction of oxidative stress may play a role in the anti-inflammatory effect of the novel herbal formulation in a rat model of hydrochloric acid-induced cystitis (Bae, W. J. et al., Neurourology and urodynamics 34, 86-91, 2015). In addition, it was also disclosed that bladder oxidative stress and inflammation could be suppressed by a phytotherapeutic agent in a rat model of partial bladder outlet obstruction (Oka, M. et al., Suppression of bladder oxidative stress and inflammation by a phytotherapeutic agent in a rat model of partial bladder outlet obstruction, The Journal of urology 182, 382-390, 2009).
Some protection agents or therapeutic agents may be developed through the determination of ability to prevent protamine-uric acid induced cystitis of an animal urinary bladder.